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PubMed1992

Evaluation of wellness in an eating disorders program.

The evaluation of treatment effectiveness in an educational or mental health program remains an elusive and too often ignored program component. Therefore, our team of practitioners and educators in an HMO eating disorders program has developed a practical and visual evaluation method which we call the "Circle of Wellness." We define wellness in terms of physical and mental health. Wellness, in this context, is a reduction of eating disorder symptoms and improvement of quality of life and the client. The "Circle of Wellness" is not intended as a test but as a visual representation of a client's progress (pre- and post-program) for client and clinician to discuss. The tool helps identify areas to emphasize in future planning.

Attitude to Health↗
PubMedDate not supplied

The health impact of worksite nutrition and cholesterol intervention programs.

PURPOSE: To summarize and provide a critical review of worksite health promotion program evaluations published between 1980 and 1995 that address nutrition and hypercholesterolemia. The article discusses and critiques both intervention methods and research methodologies to identify the most effective strategies. METHODS: Core articles are 26 original, data-based studies that report on measures of health status, behavior, attitudes, and knowledge as outcomes of worksite nutrition and cholesterol interventions. Only work published since 1980 that clearly describes nutrition or cholesterol interventions and that includes identifiable nutrition-related outcomes is reviewed. The main search method was the same one used for this special issue; supplementary sources included those found in earlier reviews or identified through backward searches or expert contact. SUMMARY OF IMPORTANT FINDINGS: Ten worksite nutrition education programs were reviewed and were categorized as group education, group education plus individual counseling/instruction, cafeteria-based programs, and group education plus cafeteria-based programs. Four of these were randomized studies, and one used the worksite as the unit of randomization and analysis. Sixteen worksite cholesterol programs were reviewed, in five categories: monitoring; individual counseling; group sessions or classes; mediated methods using print, audiovisual, telephone, and self-help kits; and combination approaches. Of these, eight were randomized controlled trials; most tested interventions for persons with elevated cholesterol levels, although four studies reported cholesterol education programs for the general employee population. Six large controlled trials of worksite nutrition and cholesterol interventions in progress are also described. MAJOR CONCLUSIONS: The conclusions that can be drawn from this review are limited by the study designs used, which often lacked control groups, used nonrandomized designs, or relied on self-selected high-risk or volunteer participants. Our rating for the quality of the evidence in the literature as a whole lies between suggestive and indicative. It is clear that worksite nutrition and cholesterol programs are feasible and that participants benefit in the short-term. Conclusive evidence about a causal relationship between worksite nutrition and cholesterol programs and improved behavior or health is not yet available, although studies currently underway hold promise for providing more solid evidence about the potential efficacy of these interventions.

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

The Parent Satisfaction with Foster Care Services Scale.

Client satisfaction measures are an essential component of program evaluation. This article describes the development of a scale for measuring the satisfaction levels of parents whose children have received foster care services. Subjected to various statistical measures, the Parent Satisfaction with Foster Care Services Scale appears to be a reliable instrument with the promise of utility for social work researchers, practitioners, and administrators.

Clinical Competence↗
PubMed1984

The effectiveness of a slide-tape program on literature evaluation.

The effectiveness of a slide-tape program on literature evaluation skills was assessed. The slide-tape program was viewed by nine medical students (group 1) on an individual basis. Nine additional medical students (group 2) attended a lecture which addressed the same topic. Computerized questionnaire responses were obtained before and after viewing the program and the conventional lecture. No significant differences were observed between groups 1 and 2 in pre- and post-test responses (p greater than 0.05); however, significant improvement in score was observed in both groups after viewing the program and the lecture (p less than 0.05). The slide-tape program was felt to be comparable to the conventional lecture in introducing the concepts of literature evaluation.

Audiovisual Aids↗
PubMed1996

Intervention research in agriculture: examples from the swine confinement and respiratory health project.

The "Measurement and Analysis in Agricultural Interventions" workshop session of the "Intervention Research in Occupational Health and Safety: Science, Skills, Strategies" conference considered a variety of approaches to safety and health interventions in agriculture. The "Respiratory Health in Swine Confinement Project" in Iowa, an educational intervention to improve respiratory health and safety in swine confinement workers, was presented as a case study for the discussion. Results from the project were used to illustrate the advantages and disadvantages of a variety of research techniques in interventions and program evaluation, including specific issues related to measurement and analysis. The discussion reflects comments from workshop participants along with summary observations reported to conference attendees. Themes of the session include the complementary nature of quantitative and qualitative techniques, and the importance of developing interventions that are community based.

Air Pollution, Indoor↗
PubMed1997

End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations.

Computer Communication Networks↗
PubMed2004

Neonatal transitional care.

Challenging times lay ahead for very low birth weight (VLBW) infants and their families after hospital discharge. Ongoing medical concerns, respiratory complications, breastfeeding and feeding problems, inadequate growth and delayed development are frequently encountered by this vulnerable population. Families are burdened by the worry and work of caring for their VLBW infants at home. Specialized support in the community is needed to help in the transition of infants and families from hospital to home. The Neonatal Transitional Care Program (NTCP) commenced in 1997 to assist homeward bound VLBW infants and their families in the Calgary Health Region. The program team, consisting of clinical nurse specialists and a dietitian, provides in-home and telephone support for four months after infants are discharged. Extensive program evaluations reveal lengthened breast milk provision, decreased demand on healthcare resources (particularly emergency departments and pediatrician offices) and enhanced maternal confidence and satisfaction with community service. In this article, the development and evaluation of the NTCP are described. This innovative approach to caring for a vulnerable population of VLBW infants and their families is believed to be the first of its kind in North America. The NTCP models neonatal care that is seamless across the healthcare system and congruent with the needs of the infant and family.

Alberta↗
PubMed2006

The PRIME curriculum. Clinical research training during residency.

AIM: The Primary Medical Education (PRIME) program is an outpatient-based, internal medicine residency track nested within the University of California, San Francisco (UCSF) categorical medicine program. Primary Medical Education is based at the San Francisco Veteran's Affairs Medical Center (VAMC), 1 of 3 teaching hospitals at UCSF. The program accepts 8 UCSF medicine residents annually, who differentiate into PRIME after internship. In 2000, we implemented a novel research methods curriculum with the dual purposes of teaching basic epidemiology skills and providing mentored opportunities for clinical research projects during residency. SETTING: Single academic internal medicine program. PROGRAM DESCRIPTION: The PRIME curriculum utilizes didactic lecture, frequent journal clubs, work-in-progress sessions, and active mentoring to enable residents to "try out" a clinical research project during residency. PROGRAM EVALUATION: Among 32 residents in 4 years, 22 residents have produced 20 papers in peer-reviewed journals, 1 paper under review, and 2 book chapters. Their clinical evaluations are equivalent to other UCSF medicine residents. DISCUSSION: While learning skills in evidence-based medicine, residents can conduct high-quality research. Utilizing a collaboration of General Internal Medicine researchers and educators, our curriculum affords residents the opportunity to "try-out" clinical research as a potential future career choice.

Authorship↗
PubMed2001

Fostering an Internet-based work group in community health through action research.

In this article, we describe an action research study to foster an Internet-based work group as part of a two-year community health research training program in Alberta, Canada. The objectives of our study were to incorporate Internet-based technology into the program, establish a distributed work group over time, and reflect on the lessons learned. The participants represented seventeen health regions. There were thirty-five instructors and expert resource persons (varied over time), two training coordinators, four support staff, a program coordinator, two action researchers, and two independent consultants. The data collected included program documents, phone interviews, online surveys, meeting notes, online discussions, computer usage log, site visits, keystroke entry logs, help desk logs, and program evaluation reports. Content analysis was conducted with NUD*IST to identify concepts and themes from the data. Our findings suggest that role clarification, facilitative support, network linkages, and workplace learning are important aspects of fostering Internet-based work groups in a health setting, where members strive to establish themselves, seek meaning in their work, support each other, and add value to their organizations.

Canada↗
PubMed2004

A cost-related approach for evaluating drug development programs.

Most pharmaceutical statisticians make a contribution to drug development at the study level by designing and analysing clinical studies. There is less involvement at the drug project level, especially when it comes to making a strategic decision for a drug development program. Motivated by the assessment of drug safety, this paper presents a new decision rule on whether or not to continue developing a new drug based on a cost function. The cost function takes into account both type I and type II errors in a decision making problem. It also incorporates both the cost and benefit from a drug development program. This cost-benefit approach enables company senior management to evaluate a drug program objectively and make decisions in a quantitative and rational manner. The probabilities of making correct decisions are illustrated by using a real data example.

Clinical Trials as Topic↗
PubMed1991

A comparison of the cost-effectiveness of two types of occupational therapy services.

The demand for efficient and effective health care prompted this study comparing the treatment outcomes and personnel costs of two types of occupational therapy service provision for the patient with a total hip replacement. System 1 used traditional individual treatment as the primary service provision method, with group treatment used as an adjunct. System 2 used group treatment as the primary intervention method, with individual treatment as the adjunct. Program evaluation research found the study subjects to be demographically homogeneous with no difference in treatment outcomes relative to four specific functional performance goals. Direct labor costs, however, were reduced by more than one third for the System 2 patients. The results of this study suggest that for specific rehabilitation patient populations, group treatment could be a cost-effective method of occupational therapy service provision.

Aged↗
PubMed2001

RN internship: outcomes of a one-year pilot program.

Faced with a threatened shortage of highly skilled, acute care pediatric nurses, an RN Internship in Pediatrics program for new graduates was brought from vision to reality. Goals of the program were to: 1) facilitate transition of the new graduate nurse to professional registered nurse (RN); 2) prepare a beginning level staff nurse who is confident and who provides competent and safe patient care; and 3) increase the commitment and retention of new graduate nurses within the organization. A 1-year pilot program evaluation demonstrated that the interns who had an average of 8 months of RN experience were comparable or better on all measures than were control group participants who obtained up to 2 years of RN experience. A return on investment of 67.3% was established.

Adult↗
PubMed2001

Community participation in road safety: barriers and enablers.

The objectives of the paper were to identify barriers to community participation in road safety activities and to recommend strategies to reduce those barriers. Information was obtained from: a review of relevant literature, from the authors' extensive community-based experiences, from undertaking community-based research, and from interviews with key stakeholders in road safety in Western Australia. Ten significant barriers to community participation were identified. These are classified into two groups: personnel and planning issues. The former includes: reasons why people are often reluctant to become involved in projects in their communities, a lack of leadership, and a lack of skills. The latter includes: inappropriate program foci, inappropriate program evaluation, lack of resources, and a lack of sustainability. It was concluded that the barriers to community involvement in road safety initiatives are similar in many parts of Australia and overseas and apply to a wide range of health promotion interventions besides road safety. Awareness of the barriers and knowledge of their solutions can ensure that appropriate steps are taken to maximise the likelihood of community participation.

Accidents, Traffic↗
PubMed2000

Impact assessment of school-based sex education program amongst adolescents.

This was a cross-sectional, interview-based study to assess the impact of sex education on the students and the feasibility of such a program. Study sample consisted of 189 students from two secondary schools of Surat city. Impact was assessed by "before and after" administration of questionnaires. Statistical analysis was done by Z tests for difference of means and proportions. Sex education influenced the need perception and the knowledge of the students. After the training, the preferred mean age to start sex education in the two sexes converged to be 15-16 years. Doctors remained the first choice to impart the sex education, followed by school teachers. Knowledge about the STDs and the method(s) of prevention improved significantly (more in boys). Optimum days for conception became known to more students after the training and the gain was more in girls. Increased awareness about the contraceptives (condoms) use was evident in boys and (oral pills and condoms) in girls. The training improved the participation of girls in the post-evaluation program. A positive attitudinal change was observed after the training, towards extra-marital sex. It also removed the myths associated with masturbation. All students were satisfied with the programme, however, two-third of boys considered the duration insufficient.

Adolescent↗
PubMed2003

Decreasing pain and depression in a health promotion program for people with rheumatoid arthritis.

PURPOSE: To examine whether a comprehensive health promotion program for rheumatoid arthritis (CHPPRA) could alleviate patients' pain, depression, and functional disability. DESIGN: A quasi-experimental design, nonequivalent control group pretest-posttest design and a preexperimental design, one-group pretest-posttest design were used. The study was conducted in Korea. METHODS: Outcome variables (pain, depression, and functional disability) and objectives (the practice of pain-management behaviors, regular exercise, and psychosocial coping strategies) were measured in 36 Korean outpatients diagnosed with rheumatoid arthritis (RA). ANOVA/MANOVA and the Wilcoxon signed rank test were used to analyze data. FINDINGS: Participants in CHPPRA had reduced pain and depression, but did not show improvements in functional disability. In the intervention group, pain management and psychosocial coping skills were significantly improved, but exercise was not significantly altered after participating in CHPPRA. CONCLUSIONS: Although this study was limited in design, the results can be reference data for designing, using, and evaluating programs for people with RA.

Activities of Daily Living↗
PubMed2004

An incentive compensation system that rewards individual and corporate productivity.

INTRODUCTION: An economically mature health care market has led to increased cost competition. Subsequently, a perceived need for productivity-based physician compensation has developed. While some institutions have rewarded individual productivity based on specific facets of academic responsibility, such as teaching, research, and patient care, we chose to develop an incentive compensation system that rewards both individual and group productivity. PROGRAM DEVELOPMENT: We developed a physician incentive compensation system that rewards individual and group productivity by capturing multiple aspects of work activity. Faculty members are given compensation value points for clinical productivity, scholarship activities, teaching activities, service activities, and achievement of the department's goals. The system was implemented in a graduated fashion in the Department of Family Medicine at Indiana University beginning July 1, 2000. PROGRAM EVALUATION: In April 2003, all faculty physicians (n=18) participated in a survey about the compensation system. The majority of faculty view the system as a necessity for the department (72.2%); 35.2% were satisfied with the system overall; 35.3% were neutral; and 27.4% were dissatisfied or not sure of their overall satisfaction. CONCLUSIONS: A comprehensive physician incentive compensation system incorporating department goals can be designed and implemented in an academic setting.

Academic Medical Centers↗
PubMed1996

Appraisal, coping, motivational factors and gender in vocational rehabilitation.

The applicability of a model of appraisal and coping was studied in vocational rehabilitation patients (n = 31:16 men, 15 women); the selection of patients aimed at obtaining a representative patient group for studying coordinated rehabilitation within various health care districts in southern Sweden. There were four phases of data collection and model adjustment. An initial, semi-structured interview concerned various key topics (program evaluation; causal attribution regarding the problem or disease; life-crises, threats, mobbing and unjust treatment; feeling of control; current situation; future; how the interview was experienced). The second phase involved a questionnaire study of hypochondriacal and depressive symptomatology, the third the analysis of patient records, and the fourth outcome data on sickness allowances and disability pensions at a 2-year follow-up. The results indicate the importance for rehabilitation of attending to motivational factors that influence the patients' coping strategies and appraisal, and to cultural (immigrant) and gender perspectives.

Adaptation, Psychological↗